Greetings and thank you for reading my post!
34 year old male/Off and on smoker of cigarettes and marijuana throughout 20s/sometimes heavy. This is a total guess but maybe 10 pack years?
Quite smoking for good in Oct 2012 after noticing pain under left shoulder blade that was not caused by injury. Massage and chiropractic ineffective. Pain has the quality of a deep ache. It's definitely gotten worse but hard to recall exactly how much worse. Pain level varies from almost 0 to a 5/6.
Decided to address my anxiety in Nov 2012 by having a chest CT done. The scan came back all clear. Subsequently had EKG and echocardiogram. All normal.
Additional symptoms which have arisen: intermittent pain in left shoulder, left arm, under armpit, fatigue, malaise, mild shortness of breath, minor cough when eating/drinking. All symptoms intermittent except the left shoulder blade pain is fairly constant (don't notice it every minute of every day but I'm aware of it for periods of time every day). Sometimes it seems like speaking makes my back hurt more. Pain in arm/shoulder comes and goes. No significant weakness in left arm but perhaps minor weakness. Pressing on shoulder/arm when no pain is there produces no pain. Pain under left shoulder blade is more constant. Pressing on particular spot there increases pain level.
Questions:
Does pain that comes on periodically during each day qualify as 'intermittent' or would it need to cease for a more substantial period of time before returning to be considered as such?
Is the brachial plexus and upper lung area included in a chest CT scan?
Is having two CT scans in less than a year dangerous to my health?
Is a CT scan or MRI the better option for detecting pancoast tumor?
What possibilities other than pancoast should I be considering? LPR (silent reflux), DDD, muscle spasms, nerve damage, trigger points etc..
How unlikely is it to get pancoast tumor in 30s? Any statistics?
Is this all just me making myself crazy with health anxiety?
Reply # - June 24, 2013, 09:37 PM
Reply To: Questions about imaging and symptoms of pancoast tumor
For what it's worth, you're the second young person in the last 12 hours to ask whether you have a Pancoast tumor based on musculoskeletal pain. I was already concluding based on the last person who asked a series of similar questions that the internet is really creating an army of people who have become convinced that they have a Pancoast tumor based on searching the internet, and I fear that there must be one website that is just doing the entire world a terrible disservice by convincing thousands of people who don't have a Pancoast tumor that they need to fear this.
It's extremely unlikely that someone in their 30s would get lung cancer. Not impossible, but probably 1 in 1000 or more patients with lung cancer is that young. The upper lung is definitely viewed in a chest CT, so I would consider it extraordinarily unlikely that you could have a Pancoast tumor without a lung tumor being visible on a chest CT.
I'm afraid that we're going to need to establish a policy that we really can't address questions from people who don't have a diagnosis of cancer but are seeking reassurance that they definitely don't have it when they have anxiety from symptoms but no findings on a workup to support it. Our expertise is in providing information about people with an established cancer, and as a cancer doctor, my work just doesn't focus on how to go from 99% to 100% certainty that someone doesn't actually have cancer.
I sincerely hope you don't have cancer, and I think you have very good reason to be optimistic. Good luck.
-Dr. West
Reply # - June 25, 2013, 08:11 AM
Reply To: Questions about imaging and symptoms of pancoast tumor
Thanks for taking the time to answer my post Dr. West. I truly appreciate it.
To offer you an alternative theory, perhaps what you're personally experiencing is observer bias? Health anxiety, especially in regards to the big C, has always been extremely high. You happen to be one of the few oncologists who provide insightful online comments about pancoast tumors to the layperson. When someone becomes worried about pancoast tumors and starts googling the topic your posts and the grace forums pop up constantly in the search results. Thus, it's only natural for you to receive a substantial number of queries from HA suffers hoping to receive some reassurance from a top pancoast tumor expert that there's a 99.9% chance it's all in their head. Anyway, sorry for wasting your time. My grandfather died from lung cancer and I have a great deal of respect for medical professionals who fight against suffering. Rather than going for another CT scan I think I'll try going the PT route based upon your response to my concerns.
Best regards,
Don
Reply # - June 25, 2013, 10:00 PM
Reply To: Questions about imaging and symptoms of pancoast tumor
There's no doubt that we are all exposed to observer bias. I'd hate to think that GRACE is contributing to the increased anxiety people experience from searching for answers online. I would hate to lead people to presume that the symptoms that are occasionally associated with lung cancer are what people should presume they have until proven otherwise.
-Dr. West
Reply # - June 26, 2013, 08:33 AM
Reply To: Questions about imaging and symptoms of pancoast tumor
Oh no, I believe that the contribution of GRACE and yourself are awesome.
It also wasn't my intention to mean observe bias in a pejorative sense, but rather a technical one. I have no idea if internet content is fueling a rise in HA. However I do know that the more pancoast related content you provide, the larger your online presence in the search results and the more likely you are to attract... questions from people like myself...
Ok, take care.
Reply # - August 31, 2014, 08:14 AM
Reply To: Questions about imaging and symptoms of pancoast tumor
Were you able to find out the reasons behind your chest pains? My symptoms are so similar to that of you. XRAY is clear , will be going in for a CT soon.
My pulmonologist says its looks clear and wants me to refer to an ortho but somehow I have a feeling it still related to my lungs knowing for sure I have been a smoker for 10 yrs.
All the rest of stuff match your symptoms exactly.
Reply # - August 31, 2014, 11:15 AM
Reply To: Questions about imaging and symptoms of pancoast tumor
This is a non pro statement, just personal experience. I've had very similar pain for years and am an ex-smoker. I was convinced my husband was suffering from the same impinged nerve problems I was...until it became obviously more painful (falling to the floor at with the wrong touch among others) and he stopped eating and other changes. A CT scan can be expected to see a tumor causing these kinds of problems. Otherwise it's more likely muscular skeletal.
I found bikram's hot yoga helps tremendously but you've got to be of a certain mind set to follow through, it's difficult to form a regular practice of it but so worth it. The series has not postures that put pressure on you neck. It aligns your body to it's original state so well that it seems almost anything can be healed through it, except cancer. I became immersed in it for several years then moved to a city that didn't provide the classes that helped me continuously practice. 15 years later, starting and stopping a dozen times I'm 3 months in to it and feeling the benefits.
Janine